Beruflich Dokumente
Kultur Dokumente
OCULAR TRAUMA
Ocular trauma
Blunt trauma
Penetrating injury
Foreign body
Burns
After injury:
Ask about circumstances of accident
First estimation of injured eye
Examination of position and mobility of
eyeball
Examination of vision / light perception
Imaging (RTG, USG, CT)
Orbit contusion
Periorbital haematoma, subconiunctival
ecchymoses
Injury of eye lids
Intraorbital haematoma - with/without eyeball
displacement, disorders of eye mobility
Ethmoidal fracture
- orbital emphysema exophthalmus, diplopia
- subcutaneous emphysema crackling
Blow out
Lids injury
- Precise surgical treatment
is necessary.
Canalicular lacerations
should be repaired within
24h.
Improper management may
cause complications:
- improper position of eye
lids,
- Defective closure of lids
corneal ulcus
- Lacrimal obstruction
Results:
- transient or permanent ocular lesion,
- direct or indirect (late) consequences for
vision
In conjunctival sac
Under upper lid
on the cornea
Symptoms: strong
pain, red eye,
lacrimation,
photophobia
Pallor of retina
Decrease of visual acuity
Self-improvement in few
weeks
Terson syndrome
- due to acute subarachnoideal bleeding
Mechanism: acute increase
of intracranial pressure
cause rupture of tiny retinal
vessels
Preretinal haemorrhages or
in vitreous body
Usually self resorbtion in
few months
Retinal detachment
After blunt trauma
More often in myopic
eyes
Decrease of vision
Painless
Treatment: surgical
Penetrating injury
of cornea or conjuntiva and sclera
Ask about
circumstances of
accident
Seidel test
- Topical fluorescein to
check leaking of
aqueous humor from
the wound
Penetrating injury
postraumatic cataract - when the lens is
injured
opacities and swelling of lens,
displacement of damaged lens to other
compartments of the globe
complications: uveitis, secondary
glaucoma
Chemical burns
alcali burns
The most severe kind of burns
mortar, ammonia, sodium hydroxide, lime,
caustic soda
Alcali quickly penetrate the cornea and
bind with cell membrane lipids damage
of intraocular structures
Eye condition deteriorate in time
Chemical burn
Chemical burns
acid burns
usually hydrochloric
acid, laboratory acids
Less danger than
alcali cause
denaturation of
proteins which makes
the barrier against
penetrating of acid
deeper into tissue
UV burn
usually: while welding, quartz lamp (solarium),
strong solar radiation on snow
Symptoms after 6-10 h after exposition
Severe pain, photophobia, blepharospasm,
conjunctival hyperaemia, oedema of lids, corneal
epithepial erosions
Treatment :
Symptomatic only analgetics, cold compress
Symptoms ussually pass in 24h
SUMMING UP...
Ocular trauma in ca. 20% of all accidents
While helping victims of accidents:
- remember that the eyes may be injured
too,
- protect eyes from additional damage
SUMMING UP
In case of blunt trauma of the eye always
suspect and look for intraocular damage.
Always suspect intraocular foreign body and
look for it (RTG, USG) if there is such
suggestion in interview or in post-traumatic
signs.
In case of chemical burns always
remember about quick and abuondant
washing of the eye. It may influence further
vission aquity.
Thank you